Provider Demographics
NPI:1942188362
Name:ANDERSON, ERIK DARNELL SR
Entity type:Individual
Prefix:MR
First Name:ERIK
Middle Name:DARNELL
Last Name:ANDERSON
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4732 N 36TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-2247
Mailing Address - Country:US
Mailing Address - Phone:402-214-3312
Mailing Address - Fax:
Practice Address - Street 1:4732 N 36TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-2247
Practice Address - Country:US
Practice Address - Phone:402-214-3312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider